알츠하이머형 치매의 선별을 위한 K-DRS의 유용성 연구
The application of the Korean Dementia Rating Scale(K-DRS) in the diagnosis of dementia of alzheimer type
오자영 (서울아산병원 정신과)
- 다운로드 수
- 조회수
초록
본 연구는 K-DRS를 이용한 알츠하이머형 치매(DAT)환자 선별의 타당성을 검증하기 위해 수행되었다. 연구 참여자는 서울에 거주하는 20명의 DAT환자와 정신과 및 신경과적 병력이 없는 54명의 정상노인이었다. 두 집단의 K-DRS 총점 및 소검사 점수를 비교한 결과 DAT환자집단의 총점, 기억, 관리기능, 개념화, 주의 소검사의 점수가 낮았다. 검사 지침서의 총점 경계점수를 이용해 진단한 결과 민감도 35%, 특이도 98.1%가 나타났다. 하지만 로지스틱 회귀분석을 시도한 결과 기억 소검사를 중심으로 진단하면 민감도 85%, 특이도 98.1%로 나타나 민감도의 뚜렷한 상승을 관찰할 수 있었다. 본 연구결과는 지역사회에서 DAT를 선별할 때, 치매의 병리적 특성을 고려한 세부적 인지기능평가가 요구된다는 시사점을 제시한다
- keywords
- K-DRS, 알츠하이머, 치매, 선별, 진단, K-DRS, dementia, alzheimer, neuropsychology, neuropsychological battery
Abstract
The aim of this study was to examine the clinical efficacy of the Korean Dementia Rating Scale(K-DRS) as a diagnostic tool for dementia alzheimer type(DAT). The participants were 20 patients with DAT and 54 health control(HC) who were sampled in Seoul. Age and education levels of DAT group were comparable to HC group. The result of K-DRS score revealed significant mean difference between DAT and HC in total score and memory, executive function, conceptualization and attention subscales. Two groups divided by cutoff scores of K-DRS manual with 35% sensitivity and 98.1% specificity. Sensitivity and specificity increased up to 85% and 98.1% respectively, when we divided two groups by a logistic regression equation. These results suggest that the K-DRS has clinical utility in the diagnosis for dementia of Alzheimer type.
- keywords
- K-DRS, 알츠하이머, 치매, 선별, 진단, K-DRS, dementia, alzheimer, neuropsychology, neuropsychological battery
참고문헌
강연욱. (1999). 치매의 신경심리학적 평가. 대한신경과학회지, 17(Sup. 2), 6-9.
박선희. (1998). 한국판 치매 평가 검사(K-DRS)의 알츠하이머성 치매의 진단적 변별력 연구: 성신여자대학교 석사학위 청구논문.
최성혜, 이애영, 김상윤(2002). 증례를 통한 알쯔하이머병의 이해. 대한의사협회지, 45(4), 368-377.
최승원, 박은혜, 허지원, 안귀여루, 정선용, 황의완, 안창일, 김현택(2005). 알츠하이머형 치매 진단도구로써 한국판 캘리포니아 언어학습검사(K-CVLT)의 효용성 연구. 한국심리학회지: 건강, 9(4), 853-867.
최진영, 나덕렬, 박선희, 박은희. (1998). 한국판 치매 평가 검사의 타당도와 신뢰도 연구. 한국심리학회지: 임상, 17(1), 247-258.
최진영. (1998). 한국판 치매 평가 검사: Korean Dementia Rating Scale. 서울: 학지사.
탁진국 (1996). 심리검사: 개발과 평가방법의 이해. 서울: 한국가이던스
Albert, M. S. (1996). Cognitive and neurobiologic markers of early Alzheimer disease. Proceedings of the Natlonal Academy of Sciences of United States of America, 93(24), 13547-13551.
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders: DSM-IV. Washington, DC: American Psychiatric Association.
Bowler, J. V., Eliasziw, M., Steenhuis, R., Munoz, D. G., Fry, R., Merskey, H., & Hachinski, V. C. (1997). Comparative evolution of Alzheimer disease, vascular dementia, and mixed dementia. Archives of Neurology, 54(6), 697-703.
Cummings, J. L., & Benson, D. F. (1992). Dementia: A clinical approach. Boston: Butterworth-Heinemann.
Fabrigoule, C., Rouch, I., Taberly, A., Letenneur, L., Commenges, D., Mazaux, J. M., Orgogozo, J. M., Dartigues, J. F. (1998). Cognitive process in preclinical phase of dementia. Brain, 121(Pt 1), 135-141.
Fox, L. S., Olin, J. T., Erblich, J., Ippen, C. G., & Schneider, L. S. (1998). Severity of cognitiveimpairment in Alzheimer's disease affects list learning using the California Verbal Learning Test (CVLT). International Journal of Geriatric Psychiatry, 13(8), 544-549.
Hodges, J. R. Erzinclioglu, S., & Patterson, K. (2006). Evolution of cognitive deficits and conversion to dementia in patients with mild cognitive impairment: a very-long-term follow-up study. Dementia and geriatric cognitive disorders, 21(5-6), 380-391.
Hodges, J. R., & Patterson, K. (1995). Is semantic memory consistently impaired early in the course of Alzheimer's disease? Neuroanatomical and diagnostic implications. Neuropsychologia, 33, 441-459.
Jacobs, D. M., Sano, M., Dooneief, G., Marder, K., Bell, K. L., & Stern, Y. (1995). Neuropsychological detection and characterization of preclinical Alzheimer's disease. Neurology, 45(5), 957-962.
Kaszniak, A. W. (1986). The neuropsychology of dementia. In I. Grant & K. M. Adams (Eds.). Neuropsychological assessment of neuropsychiatric disorders. New York: Oxford University Press.
.Jobsta K. A., Barnetson, L. P., & Shepstone, B. J. (1997). Accurate Prediction of Histologically Confirmed Alzheimer's Disease and the Differential Diagnosis of Dementia: The Use of NINCDS-ADRDA and DSM-III-R Criteria, SPECT, X-Ray CT, and Apo E4 in Medial Temporal Lobe Dementias. International Psychogeriatrics, 9, 191-222.
Lezak, M. (1995). Neuropsychological assessment(3rd ed.). New York: Oxpord University Press.
Mattis, S. (1988). Dementia Rating Scale (DRS): Professional manual. Odessa, FL: Psychological Assessment Resources.
McKhann, G., Drachman, D., Folstein, M., Katzman,R., Price, D., & Stadlan, E. M. (1984). Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer's Disease. Neurology, 34(7), 939-944.
Monsch, A. U., Bondi, M. W., Salmon, D. P., Butters, N., Thal, L. J., Hansen, L. A., Wiederholt, W. C., Cahn, D, A., & Klauber, M. R. (1995). Clinical validity of the Mattis Dementia Rating Scale in detecting Dementia of the Alzheimer type. A double cross-validation and application to a community-dwelling sample. Archives of Neurology, 52(9), 899-904.
Nelson, A., Fogel, B. S., & Faust, D. (1986). Bedside cognitive screening instruments. A critical assessment. Journal of Nervous and Mental Disease, 174(2), 73-83.
Tranel, D., Anderson, S. W., & Benton. (1994). Development of the concept of executive function and its relationship to the frontal lobes. In F. Boller & J. Grafman(Eds.), Handbook of neuropsychology, Vol. 9(pp. 125-148). New York: Elsevier.
Vitaliano, P. P., Breen, A. R., Albert, M. S., Russo, J., & Prinz, P. N. (1984). Memory, attention, and functional status in community-residing Alzheimer type dementia patients and optimally healthy aged individuals. Jorunal of Gerontology, 39(1), 58-64.
Vitaliano, P. P., Breen, A. R., Russo, J., Albert, M., Vitiello, M. V., & Prinz, P. N. (1984). The clinical utility of the dementia rating scale for assessing Alzheimer patients. Journal of Chronic Disease, 37(9-10), 743-753.
- 다운로드 수
- 조회수
- 0KCI 피인용수
- 0WOS 피인용수